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Does anyone's insurance cover BP's?

mimzy!mimzy!
in 2nd Trimester
One of my friends said to check with my insurance company to see if they cover any portion of the cost for a breast pump.  She said her's covered most of the cost b/c her baby was considered premature.  I need to check with mine but curious if anyone else had this covered.  I didn't realize how expensive they were until I started looking into getting one.
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Re: Does anyone's insurance cover BP's?

  • historychick79historychick79
    Insurance doesn't cover it, but I can use my flex plan funds if the dr provides a note saying there was medical necessity (e.g. duct blockage)  not just preference or schedule assistance.
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  • Toots_popToots_pop member
    Maybe if your doctor "prescribes" it for some reason??
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  • earthycrunchymamaearthycrunchymama

    mine falls under durable medical equipment if medically necessary.

    I went to my insurance to talk to them about it. both offices tried to talk me into formula feeding because "it's easier." and so my nipples don't hurt. They recommended I get WIC for formula. I do NOT want formula, idiots. I came to them to ask for breastfeeding support, not to be told whats bad about breastfeeding. Stick out tongue

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  • peanut07peanut07

    I checked with mine and they do not cover it.

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  • hbwjhbwj
    I called my insurance (twice just to make sure) and my insurance doesn't cover breast pumps.  Crappy because those things are pretty expensive.  I put mine on my registery so I hope I get it at my shower.  If not I'll use the registery discount at the end to buy it.
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  • earthycrunchymamaearthycrunchymama
    Here are some common ICD-9 (Diagnosis) codes associated with the medical need for breastfeeding-related products, equipment and lactation consultations:

    COMMON ICD-9 CODES/DIAGNOSIS CODES:

    MOM

    __ Abscess of breast 675.1
    __ Abscess of nipple 675.03
    __ Cracked nipple 676.1
    __ Dermatitis Contact 692
    __ Engorgement of breasts 676.2
    __ Infections of nipple 675.04
    __ Nonpurulent mastitis 675.2
    __ Other and unspecified disorder of breast 676.3

    __ Other disorders of lactation 676.8
    __ Other specified infection of breast and nipple 675.8
    __ Retracted nipple 676.0
    __ Suppressed lactation 676.5
    __ Twin pregnancy post-partum condition or
    complication 651.04
    __ Unspecified disorder of lactation 676.9
    __ Unspecified infection of the breast and nipple 675.9

    BABY

    __Abnormal loss of weight 783.2
    __Abnormal Tongue Position 750.1
    __Breastmilk Jaundice 774.39
    __Cleft Palate/Lip 749
    __Down's Syndrome 758
    __Dysphagia 787.2

    __Failure to thrive 784.4
    __Feeding difficulty - infant 783.3
    __Feeding problems in newborn 779.3
    __Neonatal candida infection 771.7
    __Other transitory neonatal 775.5
    __ Suck Reflex Abnormal 796.1


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  • mimzy!mimzy!

    Good point on the flex plan; I'll have to check with our coverage to see if a prescribed one could get covered.  It's disappointing to hear an insurance company would try to talk a mother out of breast feeding & using formula.

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  • earthycrunchymamaearthycrunchymama

    also:

    What qualifies a breast pump as medically necessary?

    A breast pump is considered medically necessary if your baby is premature, sick, having difficulties nursing properly, or is intolerant to artificial baby milk. Your doctor may also deem a pump medically necessary if you are experiencing medical problems that prohibit you from breastfeeding, will be nursing twins or other multiples, will be physically separated from your child for long periods of time or plan to work outside the home. Also, to determine if you have flat or inverted nipples and will need to begin working with your breast before your baby is born see our article Do I Have Flat or Inverted Nipples? In certain cases when breastfeeding could be compromised based on retracting nipples, insurance could help you to attain a pump to prepare for breastfeeding.

    When explaining why your breast pump is medically necessary, your doctor will use an ICD-9 Code to communicate your diagnosis to your health insurance company.

    Breastfeeding Related ICD-9 Codes
    Child
    Cleft palate/lip 749
    Abnormal tongue position 750.1
    Down?s syndrome 758
    Neonatal candida infection 771.7
    Breastmilk jaundice 774.39
    Other transitory neonatal 775.5
    Feeding problems in newborn 779.3
    Abnormal loss of weight 783.2
    Feeding difficulty ? infant 783.3
    Failure to thrive 784.4
    Dysphagia 787.2
    Suck reflex abnormal 796.1
    Mother
    Twin pregnancy post-partum condition or complication 651.04
    Abscess of nipple 675.03
    Infections of nipple 675.04
    Abscess of breast 675.1
    Nonpurulent mastitis 675.2
    Other specified infection of breast and nipple 675.8
    Unspecified infection of the breast and nipple 675.9
    Retracted nipple 676
    Cracked nipple 676.1
    Engorgement of breasts 676.2
    Other and unspecified disorder of breast 676.3
    Suppressed lactation 676.5
    Other disorders of lactation 676.8
    Unspecified disorder of lactation 676.9
    Dermatitis contact 692

     

     

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  • pgin08pgin08
    I was lucky - my ins. covered mine at 90% without it being medically necessary - definitely call to find out because my insurance didn't advertise this coverage  . . .I was glad I asked!
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  • BlondiePhDBlondiePhD member
    My insurance gives $200 for a breast pump.
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  • mrsadamc 05mrsadamc 05 member

    I know my hospital rents them out and they are really high quality and much more resonable than purchasing.  

    You might consider that option.

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  • Mrs.BielaMrs.Biela
    My insurance stated they would only cover a bp if the baby had cleft palate or if there would a long seperate between mother and baby.  And to make matters better, my medical flex spending plan does not cover this either.
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  • Skyqueen737Skyqueen737
    imageearthycrunchymama:

    also:

    What qualifies a breast pump as medically necessary?

    A breast pump is considered medically necessary if your baby is premature, sick, having difficulties nursing properly, or is intolerant to artificial baby milk. Your doctor may also deem a pump medically necessary if you are experiencing medical problems that prohibit you from breastfeeding, will be nursing twins or other multiples, will be physically separated from your child for long periods of time or plan to work outside the home. Also, to determine if you have flat or inverted nipples and will need to begin working with your breast before your baby is born see our article Do I Have Flat or Inverted Nipples? In certain cases when breastfeeding could be compromised based on retracting nipples, insurance could help you to attain a pump to prepare for breastfeeding.

    When explaining why your breast pump is medically necessary, your doctor will use an ICD-9 Code to communicate your diagnosis to your health insurance company.

    Breastfeeding Related ICD-9 Codes
    Child
    Cleft palate/lip 749
    Abnormal tongue position 750.1
    Down?s syndrome 758
    Neonatal candida infection 771.7
    Breastmilk jaundice 774.39
    Other transitory neonatal 775.5
    Feeding problems in newborn 779.3
    Abnormal loss of weight 783.2
    Feeding difficulty ? infant 783.3
    Failure to thrive 784.4
    Dysphagia 787.2
    Suck reflex abnormal 796.1
    Mother
    Twin pregnancy post-partum condition or complication 651.04
    Abscess of nipple 675.03
    Infections of nipple 675.04
    Abscess of breast 675.1
    Nonpurulent mastitis 675.2
    Other specified infection of breast and nipple 675.8
    Unspecified infection of the breast and nipple 675.9
    Retracted nipple 676
    Cracked nipple 676.1
    Engorgement of breasts 676.2
    Other and unspecified disorder of breast 676.3
    Suppressed lactation 676.5
    Other disorders of lactation 676.8
    Unspecified disorder of lactation 676.9
    Dermatitis contact 692

     

     

    At the bold and underlined, I hope this works in my favor as I am a flight attendant. 

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  • teamstainsbyteamstainsby

    I just found out from a friend that her insurance carried it "if medically necessary".  According to her, she just asked her doc and the doc wrote a prescript for it.  And it's the good one (medela).

     So I called my insurance and they said "if medically necessary" all I need is a prescript from the doctor.  So I'm going to ask her about it since I'll be working and will need to pump. 

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  • flippy1234flippy1234
    Mine covers a manul breastpump only, lame!
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  • TulipsAndChampagneTulipsAndChampagne member

    Mine covers a rental only, and if medically necessary.

    When I said, well, the pump I want is $250 and the rental is $98 a month...in less than 3 months, the cost of renting would cover the purchase...all she could say was...I know, but I do not make these rules. ::shrug::

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  • h2babeh2babe member
    I just found out that mine is. But I need to get a prescription from the doctor. One of my friends just did this yesterday and she got a nice hospital grade pump.
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